When faced with an unwell child, parents often find the healthcare system (GPs, pharmacists, urgent care centers, walk in centers, minor injuries units, out-of-hours GP services and A&E departments) confusing to navigate. When they are unable to access local services in a timely fashion, they often end up seeking help from highly responsive services such as A&E departments and 999 ambulances. This in turn places increased strain on these already overstretched services.

Over the past few years, there has been a trend of increasing numbers of children being admitted to hospital, often with relatively mild conditions such as respiratory tract infections, fever and gastroenteritis, for durations of less than 24hrs. A number of these children could potentially be managed at home if more robust local services were available, which would in turn improve patient experience. In addition, by overwhelming the urgent care system with children who do not require medical intervention, there is a risk of exposing children who are seriously unwell to sub-optimal care.

This initiative aims to look at how acute care could be better delivered to serve the needs of children and young people in Wessex. We will initially focus on children under the age of 5yrs with common illnesses.

By working with key stakeholders from across Wessex, a number of core principles and potential areas for improvement have been identified by mapping the patient journey.

Core Principles

Parents feel empowered about whether and when they need to seek the advice of a healthcare professional.

Parents are clearly signposted to appropriate healthcare services when required.

At every point of contact, the healthcare practitioner (doctor, nurse, paramedic, pharmacist) should have a clear understanding of the limits of their own competence and when and where to seek guidance.

Parents should receive consistent and appropriate advice across the whole urgent care system.

Standardisation of local referral pathways and clinical guidelines across the whole acute care system, which are understood by all healthcare practitioners.

Effective communication and information sharing between healthcare practitioners and services across the whole acute care system should be in place.

The review was co-produced between NHS Dorset Clinical Commissioning Group (CCG) (the organisation responsible for Commissioning – or planning and securing – healthcare in Dorset), Dorset HealthCare (DHC) and people who use services and carers plus a range of other external phttp://www.kenthousehealthcentre.org.uk/News/2a05a969-c19b-4af6-93db-b7378c0f4c10#artners including all the local authorities. Co-production means that the options have been developed working together with people who use mental health services and people who work in mental health services. The approach enabled us to create options collectively.

The purpose of this review is to improve services for people who experience serious mental illness, and for those who at times, may be in need of crisis/acute mental health care.

This is because people who use services told us that they are not meeting their needs. People who work in mental health also told us that services were not supporting people as well as they could.

People who work in mental health services also told us that services were not working as well as they could to meet service users’ needs, partly because the demand on services had risen which made them less able to respond when people were experiencing a mental health crisis.

The review has been undertaken in stages: data and needs analysis, view seeking and modelling. We are currently within stage four, public consultation

Copies can be requested via involve@dorsetccg.nhs.uk or picked up from our reception

]]>http://lymebaymedicalpractice.co.uk/mental-health-acute-care-pathway-review/feed0Modern Day Nursing in General Practicehttp://lymebaymedicalpractice.co.uk/modern-day-nursing-in-general-practice
http://lymebaymedicalpractice.co.uk/modern-day-nursing-in-general-practice#respondFri, 21 Apr 2017 10:44:45 +0000http://lymebaymedicalpractice.co.uk/?p=642As many of you are aware the role of the nurse has changed significantly in recent years with them, following additional training, taking on many responsibilities which were formerly performed by doctors. This is for many reasons including many functions being more appropriately performed by nurses, maintaining access for patients, increased demand with limited resources and there not being enough doctors. This can be confusing for patients especially when they are directed to a nurse rather than a doctor.

Here at Lyme Bay we have embraced this approach as we believe it offers better access to the right person at the right time for our patients. Both our nurses have undertaken significant additional training which enables us to offer a broader range of nurse led services.

Sally Cable

Sally is a former midwife and can offer a full range of Women’s Health Services including antenatal and postnatal support, family planning, menopausal advice and smears. In addition she can perform bladder scanning so can offer a full continence advice and support service She also has further training and expertise in management of longterm conditions including diabetes, asthma, COPD and hypertension. Minor illness training is a further area where she has extended skills so uses these to offer same day urgent access and Friday afternoon open access at the practice. She will also undertake some home visits.

A very significant change has been the ability of nurses to prescribe drugs. Sally has completed a specialist course which enables her to work as an Independent Prescriber. She is therefore permitted to prescribe any drugs within her wide area of competence. This includes antibiotics, painkillers, inhalers, blood pressure drugs, contraceptive pills etc.

Anita Boydon

Anita has many years training in Emergency Medicine and General Practice. She also can provide advice for long term conditions, women’s and children’s health including smears. Health checks, Carer support and coordination of palliative care in the practice. She will soon complete additional training in minor illness.

As the nurses can provide these extended roles it enables the GP more time to deal with more complex conditions.

From May 2017 Sally and Anita will both be working at Lyme Bay on 5 days per week. This means that we will have increased appointments particularly later in the day thus offering better access for everybody.

Alison Robinson opened the meeting by introducing Joanna Bazalgette (Dementia Consultant), formerly of The Alzheimer’s Society, whose group provides health related educational programmes in particular iSpace and how they work together with GP Surgeries to make them a Dementia Friendly Practice. It is a free service supported by the CCG. It has been identified that 850,000 people have been diagnosed with, or are in the process of being diagnosed with dementia (40,000 in Wessex, of which 14,000 are in Dorset with numbers growing all the time). iSpace is based on a programme by Royal College of Nursing and has been adjusted for GP surgeries, as opposed to hospitals. The aim of iSpace is to allow people to feel they can use communities and have the support they need once they have been diagnosed. Each Practice accredited as Dementia Friendly will have at least one Dementia Champion to keep the work going after being accredited, and who will participate in the Dementia Champions Network Group to help adhere to best practices and to help continuity of care. First meeting of Champions Network Group will be in Poundbury at the beginning of November and hopefully one further west at a later date. iSpace encourages identification of carers and supporting carers of those with dementia. Joanna also mentioned Wayfarers and Dorset Advocacy Service which has a specific dementia department. The proximity of Lyme Regis was discussed and Healthcare Devon and whether patients could possibly use both Dorset and Devon services. iSpace also encourage the use of ‘Personal Care Plans’, and ‘This is Me’. JB outlined how crucial these are. They can be obtained from Alzheimer’s Society (available to surgeries at a cost of £5 for 25). Also suggested surgeries make their own ‘memory information packs’. JB explained the importance of making the surgery environment more user friendly for dementia sufferers – with more natural light, the use of colouring (for example on toilet seats and grab rails) and the importance of signage. JB talked of a D.E.E.P. Group (The Dementia Engagement and Empowerment Project) to be set up so Dementia sufferers could themselves have a say in what they want GP surgeries to do. It was stated that Lyme Regis community support is excellent and is working towards being a dementia friendly community.

April Boyle – Practice Manager Charmouth Surgery – spoke with us about the walk through and recommendations made in order to make Charmouth dementia friendly. Suggestions from iSpace included new signage, de-cluttering, iSpace training and review of antipsychotic medications. Also discussed was the changing of read codes to “Carers of someone with dementia” – and the possibility of telephoning someone with dementia on the morning of their appointment.

Caroline Powley offered to be a dedicated volunteer to help people with dementia to come to the surgery.

We spoke of a Home Safety Falls Prevention event run by POPPS and Dorset & Wiltshire Fire & Rescue, a home safety event at The Marine Theatre 9.30-12.30 Wednesday 19 October.Joanna Scotton AGE UK

Joanna offers a toenail cutting service on behalf of Age UK on a Monday 9am – 1pm at Lyme Regis Medical Centre. A private toe-nail cutting service costs £25-£30 and Age UK are able to offer this service for £12.50. There is an additional charge of £12.50 on patient’s first visit to cover the cost of their own set of clippers. When someone calls her for their first appointment there is generally a two week wait until they can be seen. Thereafter, people usually attend every 6-10 weeks. There are leaflets in reception and Joanna can be contacted directly on 07817 568416. She also attends in Charmouth Surgery, in the Community Room. Joanna is happy to see anyone in the area – not just patients of LRMC, Charmouth and Lyme Bay. If patient develops issues whilst on the programme, Joanna can refer to podiatry.

Nicola Pettitt – Physiotherapist LRMC

Nicola spoke of the new Self-Referral Service to Physiotherapy that is now available to patients. Referral forms are available from Reception or can be found on-line through our website. They need to be completed and returned to us. Patients will be offered their first appointment within 4-6 weeks. It is not quicker than a GP referral, but just a different entry point. 50% of physiotherapy patients now come in through the self-referral system and is available to patients of all three surgeries. Patients can subsequently be referred onwards to the Hydrotherapy Pool in Axminster (excellent for knees, hips and back pain) – this would be free for six weeks and thereafter payable.

Maggie Beart – Occupational Therapist for the Commuity.

Maggie began by outlining the service that is offered. She works three days a week and Katy Edmunds works two days a week. In addition to seeing patients in their homes they also provide the service in nursing homes, e.g. washing, cooking and bathing advice. They provide and suggest adaptive equipment to enhance patients’ lives, help them adapt and prioritise and come to terms with realising what they are capable of. OT’s have access to six intermediate care bed in Lyme Regis Nursing Home which helps to prevent hospital admissions. Their aim is to get people back to a level that is supportable to their safety and satisfaction within six weeks. Patients can self-refer to Occupational Therapy through their direct line 01297 446117. She spoke of Safe and Independent Living (SAIL). It is a Dorset-wide partnership between local authorities, Dorset & Wiltshire Fire and Rescue Service, Dorset Police, voluntary organisations, local groups and services, Dorset Energy Advice Service Centre, Age UK and the local health service.

SAIL can provide people with additional support, services or information, including: Fitting free smoke detectors and having a home safety check;

A home energy check and information about grants for insulation;

Benefit checks to ensure that people are receiving everything that they are entitled to;

Debt advice;

Signposting to local social opportunities such as lunch clubs, exercise classes or learning centres;

Signposting to falls prevention services; and

Support to live a healthier lifestyle.

LRMC run a six-week “Better Balance Course” – patients need to be referred through their GP. It is run by a Health Care Assistant and supervised by Maggie Beart. It was noted that this course was rated as outstanding by the CQC.

Finally Maggie spoke briefly about IT technology; because of the age demographics of rural Dorset is was perhaps not particularly appropriate for the majority of our patients.

Sarah Hill – Practice Manager Kent House

Sarah spoke of Lyme Bay PPG meeting who looked at “Health and Wellbeing in the Community Day” next springtime to increase awareness for people in Lyme Regis. It was generally felt that it would be a good idea for all three surgeries to be involved and it would bring together organisations to represent Health and Wellbeing in the Community e.g. Fire and Safety, Healthy Eating, Blood Pressure etc. In Adrian’s absence it was suggested that he might like to pull it all together.

Online services

We spoke of the need to promote the use of online services by our patients. All three separate PPG’s shall discuss and bring together ideas at next PPG Locality meeting.

Self Care Week 2016

We ran out of time at this meeting. To be discussed at next meeting.

To close, Alison Robinson asked how people felt about this meeting of all three Surgeries. It was agreed that it had been a very powerful meeting and should continue – perhaps every six months.

]]>http://lymebaymedicalpractice.co.uk/joint-ppg-meeting-17th-october-2016/feed0Winter Newsletter 2016http://lymebaymedicalpractice.co.uk/winter-newsletter-2016
http://lymebaymedicalpractice.co.uk/winter-newsletter-2016#respondFri, 17 Feb 2017 11:09:35 +0000http://lymebaymedicalpractice.co.uk/?p=653Welcome to our latest newsletter. The year has passed very quickly and we are again into the flu injection season. There is now very little seasonal variation in demand for services and, as you can see in the media, the NHS continues to be very busy and under pressure. As we move deeper in the Winter and Festive Season I would strongly advise you have a flu injection and read the “Self Help” section later in this Newsletter.

In the wider health community Dorset Clinical Commissioning Group launched the public consultation for its Clinical Services Review on December 1st. This is a wide ranging review about the future healthcare in Dorset. I would encourage you to get involved if you can.

In the surgery we have recently introduced a few innovations. These include mobile texting of appointments, a mobile App and increased services through our website. More and more electronic connectivity including medical records is happening across the NHS so if you are able to,use the electronic services as much as possible.

I am delighted to announce the arrival of a new dentist, Renata Smailyte who is originally from Lithuania; however has been practicing in this country for many years, most recently in Nottingham. She joined us on November 27th and provides care on 5 days per week. In addition to her NHS work, she is offering certain specialist private procedures. A list of these will be available soon and appointments are available for new registrations.

I hope you enjoy our Newsletter and all good wishes for Christmas and the New Year.

Dr Forbes Watson

Sally Cable

Triage

The duty doctor and prescribing nurse have a mixture of pre-booked and emergency appointments each working day. The emergency appointments are allocated each morning according to the triage system. Triage is the practice of sorting emergency patients into categories of priority for treatment. We ask that patients to ring as early as possible after 8am if they have a concern that they feel needs reviewing that day. A Clinician will call the patient back and depending on the nature of the problem it may be sorted by a telephone consultation, an appointment that day or an appointment on a different day may be offered. The triage system has been running for several months and has proved effective in prompt, appropriate access for patients.

On the day telephone calls

Please ensure that when requesting a GP telephone call, you make sure we have the correct contact details and also that you will be available to receive the call. A high percentage of return calls made by the GP go unanswered by patients.

Blood/Test Results

Since our telephones are very busy in the early morning, we ask you to telephone for test results (e.g. blood, urine, X-ray) on 01297 443399 between 14:00 and 16:00 Monday to Friday

Please note that we do have a strict policy regarding confidentiality and data protection. In this respect we will only give out results to the person they relate to unless that person has given prior permission for their release or if they are not capable of understanding them

Vaccinations

Flu

Flu season is upon us. Those eligible for flu immunisation are those aged over 65, children and adults with long term health conditions such as COPD, asthma, heart disease and stroke, pregnant women and carers. If you are unsure if you are eligible please enquire with Lead Nurse Sally Cable. Clinics have now been set up so please book into one.

Shingles Vaccine

Those patients who are aged 70 or 78 on 1st September 2016 are eligible for the shingles vaccine. The cohort of patients is determined by the Department of Health and not the surgery and we are unable to vaccinate outside these ages. The surgery has sent letters out to those eligible.

If you have any queries about these or any other vaccinations please contact Sally Cable.

Lyme Bay Medical & Dental Practice – ‘NEW APP’

We have developed a new App for Apple and Android products. The App is a self-contained program that can be downloaded to be used on a mobile device. It is a smaller application of our website but mobile friendly with many things that can be done while on the move, from making appointments, checking out our latest news, contacting us by using our ‘Do it online’ or registering as a new patient and much more………..

Please use the links for Apple or Android on our website.

Online Access/Systmone Online

Since we changed our medical computer clinical system last year which enabled us to offer online access to all of our patients, we have been very pleased with the number of patients who have registered for this service. Systmone Online enables you to re-order prescriptions (from a printed list of all your repeat medication), book GP appointments and view your medical summary record which includes all medication, allergies and a basic medical summary.

For those patients who have not already registered and to enable you to access this, the information you will need is a unique user ID and password which can be provided by the surgery. This can be obtained by asking at reception on your next visit or by emailing confirmation that you are happy to have the information returned via email (this is only available if you have a personal email address).

Once you have received this information, you can then log on to the website which is shown on your activation letter or via the “Do it Online” tab on our websitewww.kenthousehealthcentre.org.uk

We would encourage all our patients who have not yet done so to register for this service as soon as possible.

Mobile Telephone Numbers and Contact Details

We are now able to send mobile text confirmation for appointments which have been booked and reminders. In order for this to work efficiently we would ask that you make sure that your contact details are kept up to date. Please inform Reception as soon as possible of your new telephone number, especially your mobile number and address.

Lyme Bay Medical and Dental Practices Website/facebook

Our website www.kenthousehealthcentre.org.uk is full of information regarding our surgery, staff and facilities both here and locally. You are able to order prescriptions, fill in registration forms, travel forms, change patient details and find out up to date information including the dates for our Saturday surgery. Dental information and registration forms are located under the “dental tab”.

If there is anything else you would like to see on our website or have any comments regarding it, please contact our Practice Manager Sarah Hill.

Our facebook page now has 115 likes, but we want more! Our facebook page is regularly updated with information both serious and fun – if you are a facebook user; we encourage you to check us out and don’t forget to “like” our page

Skydiving!

Congratulations to Dr Sally Caswell and Jo Churchill, who succeeded in their 15,000ft freefall skydive. This took place on Sunday 2nd October at Dunkeswell near Honiton. They had a fabulously sunny day with clear blue skies and amazing views and both thoroughly enjoyed it! This was Jo’s first skydive but Dr Caswell has made several previous jumps. Jo has raised £800 for MIND and she is still happy to accept donations if anyone feels they would like to contribute to this cause.

GET THE RIGHT TREATMENT

Every year, millions of us visit our GP with minor health problems that can be easily resolved without a doctor’s appointment. It is estimated that every year, 50 million visits are made for minor ailments such as coughs, colds, mild eczema and athlete’s foot. By visiting your pharmacy instead you could save yourself time and trouble.

Self-Care: Keeping a well-stocked medicine cabinet at home can help you treat many minor ailments. Colds, coughs, indigestion and many other minor complaints can all be treated with medicines that are available over the counter. Your pharmacist can advise on what you might find useful to keep in your medicine cabinet. Always follow the instructions on the labels and consult the GP if the illness continues or becomes more severe.

Self Care means knowing how to keep fit and healthy, how to deal with medicines appropriately, manage self-treatable conditions and when to seek the appropriate clinical health.

The Self-Care for Life campaign aimed to help people understand what they can do to better look after their own health and that of their family, as well as living as healthily as possible. Self-Care for Life is a vital campaign that looks at health across the spectrum, from coughs, colds and flu to Self-care for long term conditions like Type 2 diabetes, heart disease and lung conditions.

Dr Martin McShane, NHS England’s National Medical Director for Long Term Conditions said

“By supporting people to help themselves, we can not only improve quality of life for individuals but also use NHS services even more effectively, particularly with winter approaching when we all know our A&E services and GPs face huge demands.”

As winter approaches, the message from Self Care Week includes reminding people to ensure their medicine cabinet is well stocked and how they can get help and advice on symptoms from their pharmacist.

How NHS Choices can support you

There is a lot of information on the NHS Live Well site that will help you manage your physical and mental wellbeing, such as how to stop smoking, eat more healthily or deal with stress and anxiety. For more information visit Live Well

Kath our lady Dentist recently left us after 3 years. She will initially be working for 3 days in Torquay and is hoping to see more of the country by taking on locum work. We will miss her and wish her all the best for the future.

We are pleased also to welcome Nicky Sheppard and Linda McCarthy who have joined the Dental Team. Nicky will be working on Reception and Linda is now working in the dental surgeries and training to become a Dental Nurse, although she will be working on reception 2 days a week.

We wish all our patients a peaceful and healthy festive season (Please try to avoid the crackling and toffees this year) and we look forward to providing continuing care for you.

EMERGENCY SERVICE~ The store is actually closed to the general public but a pharmacist is available for dispensing, advice and self-care

Access to the pharmacy is via the ‘store’ back door (grey) situated on the east side of the building aligned with the most northerly trolley park. The door will be manned by a security guard who will escort patients to the pharmacy.

Either telephone the pharmacy (01392) 501093 or ring the doorbell to gain entry.